How much rates vary
Distribution of negotiated rates across all payers (price axis is log-scale). Need provider-level prices or 24+ months of history? Contact us.
Rates by insurance carrier
| Insurance Carrier | Facility/Professional | Modifier | Typical Low | Median | Typical High |
|---|---|---|---|---|---|
Aetna Setting Professional Modifier None Typical Low $57.54 Median $81.28 Typical High $102.33 | Professional | None | $57.54 | $81.28 | $102.33 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $40.74 Median $40.74 Typical High $50.12 | Professional | 52 · Reduced service | $40.74 | $40.74 | $50.12 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $16.22 Median $16.22 Typical High $20.42 | Professional | 53 · Discontinued | $16.22 | $16.22 | $20.42 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $12.02 Median $12.02 Typical High $15.14 | Professional | 55 · Aftercare only | $12.02 | $12.02 | $15.14 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $8.13 Median $8.13 Typical High $10.00 | Professional | 56 · Pre-op care only | $8.13 | $8.13 | $10.00 |
Cigna Setting Professional Modifier None Typical Low $56.23 Median $56.23 Typical High $56.23 | Professional | None | $56.23 | $56.23 | $56.23 |
Providence Setting Professional Modifier None Typical Low $60.26 Median $79.43 Typical High $79.43 | Professional | None | $60.26 | $79.43 | $79.43 |
1 more rate with less common billing modifiers
A modifier changes what was billed, for example a reduced or repeated service. Each of these modifiers carries under 10% of the published rates for this code. Modifier combinations, and modifiers with fewer than 30 rates for a carrier, are not listed.
| Insurance Carrier | Facility/Professional | Modifier | Typical Low | Median | Typical High |
|---|---|---|---|---|---|
MountainHealth Co-op Setting Facility Modifier CSTM-00 Typical Low $323.59 Median $323.59 Typical High $524.81 | Facility | CSTM-00 | $323.59 | $323.59 | $524.81 |
Where Montana sits
The same service costs 13.8 times more in Indiana than in Pennsylvania. Every bar is a state, most expensive first. Touch or drag across it to read any state, then open that state for its carriers and full range.
Montana· 32nd of 51
$79.43
Median negotiated rate in each state, from every insurer that publishes one. States where no insurer publishes a rate for this service are not shown.